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Background: Adolescent substance use (SU) remains a serious problem. Inpatient, primary care, and self-treatment models for chemical dependency (CD) yield varying degrees of success impacting the sequelae of chronic or episodic SU. Relational engagement among adolescent substance users is a long known influential factor in the development, maintenance and transformation of addictive behaviors. Objectives: Following tenets of Relational-Cultural Theory and using the Relational Health Indices for Youth (RHI-Y), a validated survey tool for adolescents, we sought to measure relational health (RH) during times of transitions during CD treatment. This article addresses use of the tool and its potential for improving addictions research and practice. Methods: During 2015-2017 we explored differences in RH scores in adolescent girls entering inpatient CD treatment at three points: 51 at admission, 39 at discharge, and 13 at 3 months post-discharge. Data were analyzed using a generalized linear mixed model to compare changes in domain scores of RH. Results: Changes in RH scores were significant in the friend domain, but not the mentor and community domains. The RHI-Y shows promise in discerning RH change during transitions in CD treatment. [ABSTRACT FROM AUTHOR]

Background: Lyric analysis is a commonly utilized music therapy intervention for clients in substance abuse rehabilitation wherein participants interpret song lyrics related to their clinical objectives. For these patients, working alliance and trust in the therapist represent consequential factors that may influence outcomes. However, there is a lack of randomized controlled music therapy studies investigating working alliance and trust in the therapist within lyric analysis interventions for patients with addictions. Objective: The purpose of this study was to quantitatively differentiate live versus recorded and educational versus recreational music therapy interventions via measures of working alliance and trust with patients on a detoxification unit. Method: Participants (N = 130) were cluster randomized in a single-session posttest-only design to one of four conditions: Live educational music therapy, recorded educational music therapy, education without music, or recreational music therapy. Dependent measures included working alliance and trust in the therapist. Educational music therapy interventions were scripted lyric analyses. Results: There was no statistically significant between-group difference in any of the measures. Although not significant, a greater number of patients and research participants attended live educational music therapy sessions. Conclusions: Between-group descriptive data were consistently similar but attendance trends may have implications for engaging patients and billing. Implications for clinical practice, limitations of the study, and suggestions for future research are provided. [ABSTRACT FROM AUTHOR]

This exploratory and quantitative study presents a model of treatment success of the nation's oldest and largest chemical dependency treatment provider for the gay, lesbian, bisexual, and transgender (GLBT) population. The main purpose is to examine the potential ability of the predictor variables' degree of affiliation with Alcoholics Anonymous (AA), the severity of chemical use, the strength of a higher power relationship, attitudes about sexual orientation, and length of time in treatment to predict length of time clean and sober. The proposed model demonstrated the ability to explain 29% of the variance in time clean and sober. Results lend tentative support for culturally competent treatment and include specific intervention recommendations for professionals, including social workers, chemical dependency counselors, and therapists. [ABSTRACT FROM AUTHOR]

This article addresses the use of group work in a community-based outpatient children's mental health agency to respond to financial threats by county and state government during the economic downturn of 2008-2009. Three specific threats that came within months of one another are discussed: (1) the threat to close down a chemical dependency treatment service for youth, (2) severe funding cuts to an outreach program for immigrant youth and their families, and (3) a state government plan to restructure/reform reimbursement for outpatient mental health services that promises to reduce access to care for underinsured families. Group work was used to organize, educate, and activate staff, board, community, and consumer groups, in large and small groups, to counter the threats and build a culture of advocacy. Lending a vision, empowering advocates, managing polarity, and shaping the advocacy message were essential elements of the advocacy process. [ABSTRACT FROM AUTHOR]

Research suggests that gender-specific treatment for women with chemical dependency issues might be more effective than dual-gender programs. Several authors have posited that this might be due to the fact that women in treatment have differing sets of presenting problems than men. The purpose of this exploratory qualitative study was to investigate women's experiences in a single-gender, holistically focused chemical dependency treatment program. Results based on focus group interviews with 23 women suggest that the variables of empowerment, holistic services, children in treatment, domestic violence services, cohesion, and staff characteristics have distinct effects on women's experiences in chemical dependency treatment. Questions for further study are offered. [ABSTRACT FROM AUTHOR]

Introduction. This study is a long-term follow-up of an early replication of the Peniston EEG biofeedback (EEG-BFB) Protocol for chemical dependency (Peniston & Kulkosky, 1989, 1990). Method. This clinical trial included 16 chemically dependent adult participants treated with the Peniston Protocol in a university outpatient clinic between 1993 and 1995. Ten participants were probationers classified as high risk for rearrest. Treatment effects were assessed using pre/posttreatment measures (Beck Depression Inventory, Minnesota Multiphasic Personality Inventory-2) and long-term follow-up of abstinence and rearrest rates. Probationer rearrest rates were compared to an equivalent probation sample (n = 24) that did not receive EEG-BFB. Results. Initial Beck Depression Inventory scores indicated mild/moderate depression but were significantly reduced posttreatment to within normal limits. Substantial differences were noted posttreatment on 7 Minnesota Multiphasic Personality Inventory-2 clinical scales suggesting less psychopathology following treatment. Long-term (74-98 months) follow-up indicated that 81.3% (n = 13) participants were abstinent. Rearrest rates and probation revocations for the probationer subgroup were lower than the comparison group (40% vs. 79.16%). Conclusion. This study provides evidence of the durability of Peniston Protocol results over time but has the usual limitations of a clinical trial with a small sample, nonrandomized, and uncontrolled design. Implications for further research are discussed including the relevance of recent modifications to the Peniston Protocol and qEEG-based protocols in treating substance abuse. [ABSTRACT FROM AUTHOR]

The issue of co-occurring disorders is of concern to the Criminal Justice field, including drug courts. To assess the potential co-occurrence of substance use- and mental health-related diagnoses, the Psychiatric Diagnostic Screening Questionnaire and similar instruments was administered to suburban drug court clients. Based on the screening, one quarter to one half of the 108 participants would be referred for follow-up for a mental health issue; women would be referred at a greater rate than men. There is a need to develop appropriate, brief mental health screening instruments for use in drug court settings so that clients can receive necessary services. [ABSTRACT FROM AUTHOR]

Objectives: To determine the prevalence of history of head trauma, causes of such trauma, and the associated chronic sequelae in a sample of women in chemical dependency treatment programs. Participants: A total of 2,198 females of varied ethnic and racial backgrounds participating in substance abuse treatment programs. Measure: Head trauma questionnaire eliciting information via subject report on history of head trauma, cause of such head trauma, and specific chronic sequelae resulting from the head trauma. Results: Nine hundred thirty (42.3%) of the subjects reported history of at least one head trauma; 754 (34.3%) reported the head trauma having had occurred by another person. Data on reported chronic residual sequelae from the head trauma as well as breakdown by ethnic/racial group is also provided. Conclusions: The prevalence of history of head trauma along with reported sequelae as a result of such in this sample suggests that head trauma may certainly be a significant factor in persons presenting for substance abuse treatment. Assessing for a history of head trauma and associated sequelae in persons presenting in substance abuse treatment programs may be clinically appropriate as such sequelae have been found to adversely affect treatment progress. Further discussion on implications of the results of this research as well as discussion on further research in the area are provided. [ABSTRACT FROM AUTHOR]

This paper reviews the literature on women's chemical dependency and its effects on their children. Many risk factors (e,g., a history of traumatic exposure) and consequences (interference with parenting) of substance abuse are unique for women, giving rise to special treatment needs of substance-abusing women with children. Substance-abusing mothers also experience unique barriers to receiving the services they need to recover, such as absence of child care and lack of gender-specific treatment in their communities. Model programs are described and recommendations are offered for best treatment practices for women with chemical dependency who present in the child welfare system. [ABSTRACT FROM AUTHOR]

This project gathered survey information from physicians, physician assistants, dentists and pharmacists in Arizona who, while enrolled or following a completion of a monitored aftercare program, had relapsed back to active chemical dependency. The findings suggest several subjective factors that contributed to the subjects' relapse included (1) dishonesty to self, (2) not working a 12 step program, and (3) denial of the problem. Factors reported to be helpful for future relapse prevention were (1) abstinence from substance use, (2) working a 12 step program, and (3) having spiritual beliefs. In general, survey respondents were male, averaged 52 years of age, had relapsed several times and started abusing illicit drugs and alcohol in high school or college. By identifying the specific causes of relapse, future studies may attempt to decrease the percentage of health care providers who relapse by recognizing signs of problematic behavior before they occur. [ABSTRACT FROM AUTHOR]

This article presents the results of a qualitative study on lesbians' recovery from addiction. The study involved semi-structured interviews with 20 lesbians in recovery from addiction and was analyzed using grounded theory method. The central theme that emerged was self-acceptance, both as a lesbian and as a recovering alcoholic/addict, with considerable interaction between the two. Categories that contributed to this theme were learning to recover, relationships with other people, and relationship with something bigger than self. The discussion addresses how this information can be used to assist lesbians trying to recover from addiction. [ABSTRACT FROM AUTHOR]

Unlabelled: This study examined whether an EEG biofeedback protocol could improve outcome measures for a mixed substance abusing inpatient population.Method: One hundred twenty-one volunteers undergoing an inpatient substance abuse program were randomly assigned to the EEG biofeedback or control group. EEG biofeedback included training in Beta and SMR to address attentional variables, followed by an alpha-theta protocol. Subjects received a total of 40 to 50 biofeedback sessions. The control group received additional time in treatment equivalent to experimental procedure time. The Test of Variables of Attention (TOVA), and MMPI, were administered with both tester and subject blind as to group placement to obtain unbiased baseline data. Treatment retention and abstinence rates as well as psychometric and cognitive measures were compared.Results: Experimental subjects remained in treatment significantly longer than the control group (p <0.005). Of the experimental subjects completing the protocol, 77% were abstinent at 12 months, compared to 44% for the controls. Experimental subjects demonstrated significant improvement on the TOVA (p<.005) after an average of 13 beta-SMR sessions. Following alpha-theta training, significant differences were noted on 5 of the 10 MMPI-2 scales at the p<.005 level.Conclusions: This protocol enhanced treatment retention, variables of attention, and abstinence rates one year following treatment. [ABSTRACT FROM AUTHOR]

A self-administered, CD-ROM-based, interactive multimedia psychoeducational intervention, called Working It Out, was developed to improve employment functioning for clients in substance dependency treatment. The computer-based program's effectiveness was tested in comparison with printed material. During 2000–2001 194 clients with employment concerns in six treatment programs were randomly assigned to a CD-ROM or print material condition and evaluated at baseline and 6 months later. A main effect for improvement was observed on employment indices, but there was no condition-by-time interaction. Results suggest that clients are willing and able to use vocational rehabilitation information presented in any format, although the CD-ROM-based program received significantly better satisfaction ratings than did the print material. [ABSTRACT FROM AUTHOR]

This article examines racial/ethnic differences in a sample of 51 dually diagnosed women who received chemical dependency treatment. Comparisons are made between Anglo and racial/ethnic minority women at admission to the inpatient treatment program and at follow-up where data are available. Findings from a repeated measures design showed significant decreases in several problem domains for the overall sample. Significant racial/ethnic differences were found only for the other drugs domain. Anglo women reported greater decreases than racial/ethnic minority women in the majority of the domains. Findings suggest continued investigations to inform culturally competent treatment for all dually diagnosed women. [ABSTRACT FROM AUTHOR]

This paper describes the development and utilization of a performance measurement system installed in the case management program for chronic substance abusers who are committed for chemical dependency treatment in Hennepin County, Minnesota. The system (operational for over four years) produces quarterly management reports which display client characteristics at program entry as well as client outcomes achieved during and following the six-month commitment period. Institutionalization of the system within the program and the associated measurement of client characteristics and outcomes have helped to standardize case planning and to sensitize program staff to both client needs and the outcomes toward which staff and client efforts should be directed. Finally, the paper describes the special studies that have been generated from the performance measurement system's database. These include the development of caseload difficulty indices, and multivariate investigations of the relationship between client characteristics and outcomes. The paper seeks to add to the knowledge of the ways in which performance measurement systems might be designed, implemented, and used. [ABSTRACT FROM AUTHOR]

Effectiveness of Say It Straight communication training as a treatment component was evaluated with 36 mothers in residential chemical dependency treatment. All were indigent, 32 had previous criminal offenses and 14 were on probation or parole at the time of treatment. Self-reported, disempowering behaviors showed highly significant decreases after SIS training (p < 0.001). Empowering behaviors, quality of family and group life showed significant increases (p = 0.001, p = 0.008, p = 0.015, respectively). Self-esteem, assessed with one group of eight mothers, showed a highly significant increase after training (p = 0.009). Statistically significant differences between mothers in treatment an average of 40 days compared to those in treatment 141 days prior to training disappeared after 10-16 hours of training, although the latter group also showed positive changes. Reports regarding training effectiveness were very positive. Results indicate this training is an important addition to treatment and may have implication for shortened treatment time, increased treatment retention and reduction in relapse/recidivism. [ABSTRACT FROM PUBLISHER]

Current models of assessment and treatment of co-morbid Axis I anxiety disorders and chemical dependency are examined. Since the scope of this class of disorder is so heterogeneous, the most encountered disorders are discussed, including Post Traumatic Stress Disorder (PTSD); Panic Disorder (PD); Social Phobia; Generalized Anxiety Disorder (GAD); and Obsessive Compulsive Disorder (OCD). Problems encountered in past approaches to this dual diagnosis population are explored. Proposals for methods of differential diagnosis, comprehensive assessment and various modalities of service delivery are made. A discussion regarding current methodology liabilities and strengths follow a synopsis of current research. [ABSTRACT FROM AUTHOR]

The adult version of the Substance Abuse Subtle Screening Inventory-2 (SASSI-2) has proven effective in identifying chemically dependent individuals. This research examines whether adult SASSI-2 scores can change significantly from pre- to post-test administration. In the course of this research, subjects completed the SASSI-2 prior to receiving treatment and again after the completion of the treatment phase. A shift in scores was found from pre- to post-test administration for treatment subjects on both global scores, as well as on three subscales. Though limited in generalizability due to a sample size of 20, the results suggest that the adult SASSI-2 may be helpful in detecting recovery. [ABSTRACT FROM AUTHOR]

This research addresses the efficacy of Rational Recovery (RR) as a treatment modality. Two groups of ten (10) alcohol/drug dependent subjects were exposed to two different treatment approaches at an outpatient-counseling center in the Southwest United States. All subjects were given the Substance Abuse Subtle Screening Inventory-2 (SASSI-2) as a measurement of symptoms associated with alcohol/drug dependency. Findings showed that the RR group showed significant change from pre to post-test administration of the SASSI. The results indicate that RR can be an effective treatment for enhancing openness and decreasing denial for alcohol/drug dependent subjects. [ABSTRACT FROM AUTHOR]

This article focuses on lesbians in later midlife who are in recovery (for at least six months) from chemical dependency and on the ways the traumatic effects of their chemical dependency affect and influence the issues they face, the decisions they make, the actions they take, and, most especially, the relationships they have with both self and others. Although earlier midlife (from 40 to 50) is an important time, we will focus on the later years (from 50 to 60) because they seem to comprise the critical decade, the time when "old selves are lost and new ones come into being" (Stein, 1983, p. 3). [ABSTRACT FROM AUTHOR]

The treatment outcome from homogeneous age group substance abuse treatment centers, whose clientele consist of adolescent chemical dependents, has never clearly been demonstrated to be superior to heterogeneous age group treatment. An analysis of research in several disciplines concerning outcome studies related to adolescent chemical dependency and mental health treatment, demonstrates that heterogeneous (multigenerational) treatment settings may be superior to homogeneous age group treatment. Other adolescent issues in the family and society that directly affect treatment philosophies in centers directed toward youth are compared to the treatment philosophies of adult centers. It is suggested that multigenerational treatment facilities cost less, require less staff, are better received by the client, and produce higher abstinence rates than adolescent-specific centers. [ABSTRACT FROM AUTHOR]